Arlievsky NZ, Li KI, Munoz JL; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1998 Sep 24-27; 38: 363 (abstract no. I-4).

New York Medical College, Valhalla.

Protease inhibitors (PI) cause dramatic decreases in viral loads (VL) in adults infected with Human Immunodeficiency Virus (HIV). More aggressive regimens containing two PI's may be needed in children since their VL's are higher. Marked clinical, immunologic and virologic improvement was observed in a number of children with advanced HIV disease and elevated VL's who were treated with two reverse transcriptase (RT) inhibitors, nelfinavir and saquinavir. We present clinical immunologic and virologic data on these children as well as children with less severe manifestations of HIV infection who were treated with 2 RT inhibitors and nelfinavir, without saquinavir. VL's were measured by RT-PCR once before and twice after starting PI therapy (within 3 and 8 months). All of the children received no prior treatment with PI's. Seven children (Group A) were treated with the quadruple regimen and 11 children (Group B) were treated with the triple regimen. 71% of patients in Group A and 82% of patients in Group B received prior antiretrovirals. (Table: see text) The mean VL decreased by 2.2 log in Group A and by 1.4 log in Group B within 4-8 months. Three of 7 patients in Group A and 2 of 9 patients in Group B had VL's <400/ml within 4-8 months. Three patients in Group A had marked clinical improvement, and 2 patients in Group B had clinical deterioration. The 4-drug regimen with NLF and SQN was well tolerated and achieved more pronounced decreases in VL's and increases in CD4 counts in a group of patients who were sicker and had higher VL's at baseline as compared to the 3-drug NLF-only group. The reduction in VL was more sustained in the 4-drug group. A 4-drug regimen including two PI's should be considered in children with advanced HIV disease.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Adult
• Anti-HIV Agents
• Antiretroviral Therapy, Highly Active
• Child
• Drug Therapy, Combination
• HIV
• HIV Infections
• HIV Protease Inhibitors
• HIV Seropositivity
• Humans
• Nelfinavir
• RNA-Directed DNA Polymerase
• Saquinavir
• Viral Load
• drug therapy
• therapy

Other ID:

• 20710809

UI: 102188117

From Meeting Abstracts